Provider Demographics
NPI:1932978442
Name:WRIGHT, EBONY L
Entity Type:Individual
Prefix:
First Name:EBONY
Middle Name:L
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2461 SANTA ANA N
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90059-2146
Mailing Address - Country:US
Mailing Address - Phone:310-912-5817
Mailing Address - Fax:
Practice Address - Street 1:13135 BARTON RD STE ABC
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-2757
Practice Address - Country:US
Practice Address - Phone:657-242-2079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst